THE SECRETARY OF HEALTH AND HUMAN SERVICES

WASHINGTON, D.C. 20201

September 30, 2013 

The Honorable Joseph R. Biden, Jr.

President of the United States Senate

Washington, DC 20510 

Dear Mr. President:

Pursuant to the Energy Employees Occupational Illness Compensation Program Act of 2000 and 

42 C.F.R. pt. 83, a petition was filed on behalf of workers who were employed at the Pantex 

Plant in Amarillo, Texas, to be added to the Special Exposure Cohort (SEC).

The Centers for Disease Control and Prevention’s (CDC) National Institute for Occupational 

Safety and Health (NIOSH) evaluated the petition and presented its findings to the Advisory 

Board on Radiation and Worker Health (Board) on July 17, 2013. The Board considered the 

petition, and on September 3, 2013, I received the Board’s recommendation concerning this 

petition. I have also received the deliberations, findings, and recommendations of the Director of 

NIOSH and the Director of CDC. Based on this information, I have designated the following 

class for addition to the SEC: 

All employees of the Department of Energy, its predecessor agencies, and their 

contractors and subcontractors who worked at the Pantex Plant in Amarillo, Texas, from 

January 1, 1984, through December 31, 1991, for a number of work days aggregating at 

least 250 work days, occurring either solely under this employment, or in combination 

with work days within the parameters established for one or more other classes of 

employees included in the Special Exposure Cohort. 

The criteria and findings upon which this designation is based are provided in the enclosed 

report.

 

Please contact me if you have any further questions regarding this matter.

Sincerely,

[Signature on File] 

Kathleen Sebelius

Enclosure 
 

 THE SECRETARY OF HEALTH AND HUMAN SERVICES

WASHINGTON, D.C. 20201

September 30, 2013 

The Honorable Harry Reid 

Majority Leader

United States Senate

Washington, DC 20510 

Dear Senator Reid:

Pursuant to the Energy Employees Occupational Illness Compensation Program Act of 2000 and 

42 C.F.R. pt. 83, a petition was filed on behalf of workers who were employed at the Pantex 

Plant in Amarillo, Texas, to be added to the Special Exposure Cohort (SEC).

The Centers for Disease Control and Prevention’s (CDC) National Institute for Occupational 

Safety and Health (NIOSH) evaluated the petition and presented its findings to the Advisory 

Board on Radiation and Worker Health (Board) on July 17, 2013. The Board considered the 

petition, and on September 3, 2013, I received the Board’s recommendation concerning this 

petition. I have also received the deliberations, findings, and recommendations of the Director of 

NIOSH and the Director of CDC. Based on this information, I have designated the following 

class for addition to the SEC: 

All employees of the Department of Energy, its predecessor agencies, and their 

contractors and subcontractors who worked at the Pantex Plant in Amarillo, Texas, from 

January 1, 1984, through December 31, 1991, for a number of work days aggregating at 

least 250 work days, occurring either solely under this employment, or in combination 

with work days within the parameters established for one or more other classes of 

employees included in the Special Exposure Cohort. 

The criteria and findings upon which this designation is based are provided in the enclosed 

report.

 

Please contact me if you have any further questions regarding this matter.

Sincerely,

[Signature on File] 

Kathleen Sebelius

Enclosure 
 

 THE SECRETARY OF HEALTH AND HUMAN SERVICES

WASHINGTON, D.C. 20201

September 30, 2013 

The Honorable Mitch McConnell 

Minority Leader

United States Senate

Washington, DC 20510 

Dear Senator McConnell:

Pursuant to the Energy Employees Occupational Illness Compensation Program Act of 2000 and 

42 C.F.R. pt. 83, a petition was filed on behalf of workers who were employed at the Pantex 

Plant in Amarillo, Texas, to be added to the Special Exposure Cohort (SEC). 

The Centers for Disease Control and Prevention’s (CDC) National Institute for Occupational 

Safety and Health (NIOSH) evaluated the petition and presented its findings to the Advisory 

Board on Radiation and Worker Health (Board) on July 17, 2013. The Board considered the 

petition, and on September 3, 2013, I received the Board’s recommendation concerning this 

petition. I have also received the deliberations, findings, and recommendations of the Director of 

NIOSH and the Director of CDC. Based on this information, I have designated the following 

class for addition to the SEC: 

All employees of the Department of Energy, its predecessor agencies, and their 

contractors and subcontractors who worked at the Pantex Plant in Amarillo, Texas, from 

January 1, 1984, through December 31, 1991, for a number of work days aggregating at 

least 250 work days, occurring either solely under this employment, or in combination 

with work days within the parameters established for one or more other classes of 

employees included in the Special Exposure Cohort. 

The criteria and findings upon which this designation is based are provided in the enclosed 

report.

 

Please contact me if you have any further questions regarding this matter.

Sincerely,

[Signature on File] 

Kathleen Sebelius

Enclosure 
 

 THE SECRETARY OF HEALTH AND HUMAN SERVICES

WASHINGTON, D.C. 20201

September 30, 2013 

The Honorable Nancy Pelosi 

Minority Leader

U.S. House of Representatives

Washington, DC 20515 

Dear Representative Pelosi:

Pursuant to the Energy Employees Occupational Illness Compensation Program Act of 2000 and 

42 C.F.R. pt. 83, a petition was filed on behalf of workers who were employed at the Pantex 

Plant in Amarillo, Texas, to be added to the Special Exposure Cohort (SEC). 

The Centers for Disease Control and Prevention’s (CDC) National Institute for Occupational 

Safety and Health (NIOSH) evaluated the petition and presented its findings to the Advisory 

Board on Radiation and Worker Health (Board) on July 17, 2013. The Board considered the 

petition, and on September 3, 2013, I received the Board’s recommendation concerning this 

petition. I have also received the deliberations, findings, and recommendations of the Director of 

NIOSH and the Director of CDC. Based on this information, I have designated the following 

class for addition to the SEC: 

All employees of the Department of Energy, its predecessor agencies, and their 

contractors and subcontractors who worked at the Pantex Plant in Amarillo, Texas, from 

January 1, 1984, through December 31, 1991, for a number of work days aggregating at 

least 250 work days, occurring either solely under this employment, or in combination 

with work days within the parameters established for one or more other classes of 

employees included in the Special Exposure Cohort. 

The criteria and findings upon which this designation is based are provided in the enclosed 

report.

 

Please contact me if you have any further questions regarding this matter.

Sincerely,

[Signature on File] 

Kathleen Sebelius

Enclosure 
 

 THE SECRETARY OF HEALTH AND HUMAN SERVICES

WASHINGTON, D.C. 20201

September 30, 2013 

The Honorable John A. Boehner 

Speaker of the U.S. House of Representatives

Washington, DC 20515 

Dear Mr. Speaker:

Pursuant to the Energy Employees Occupational Illness Compensation Program Act of 2000 and 

42 C.F.R. pt. 83, a petition was filed on behalf of workers who were employed at the Pantex 

Plant in Amarillo, Texas, to be added to the Special Exposure Cohort (SEC).

The Centers for Disease Control and Prevention’s (CDC) National Institute for Occupational 

Safety and Health (NIOSH) evaluated the petition and presented its findings to the Advisory 

Board on Radiation and Worker Health (Board) on July 17, 2013. The Board considered the 

petition, and on September 3, 2013, I received the Board’s recommendation concerning this 

petition. I have also received the deliberations, findings, and recommendations of the Director of 

NIOSH and the Director of CDC. Based on this information, I have designated the following 

class for addition to the SEC: 

All employees of the Department of Energy, its predecessor agencies, and their 

contractors and subcontractors who worked at the Pantex Plant in Amarillo, Texas, from 

January 1, 1984, through December 31, 1991, for a number of work days aggregating at 

least 250 work days, occurring either solely under this employment, or in combination 

with work days within the parameters established for one or more other classes of 

employees included in the Special Exposure Cohort. 

The criteria and findings upon which this designation is based are provided in the enclosed 

report.

 

Please contact me if you have any further questions regarding this matter.

Sincerely,

[Signature on File] 

Kathleen Sebelius

Enclosure 
HHS Special Exposure Cohort Designation: Pantex Plant, Amarillo, Texas

 

HHS Designation of Additional Members of the 

Special Exposure Cohort 

under the 

Energy Employees Occupational Illness Compensation Program Act of 2000 

Designating a Class of Employees from 

Pantex Plant

Amarillo, Texas
HHS Special Exposure Cohort Designation:

Pantex Plant, Amarillo, Texas Page 2

I. Designation 

I, Kathleen Sebelius, Secretary of Health and Human Services, designate the class of 

employees defined in Section II of this report for addition to the Special Exposure Cohort 

(SEC), as authorized under the Energy Employees Occupational Illness Compensation 

Program Act of 2000 (EEOICPA), 42 U.S.C. § 7384q. 

[Signature on File] September 30, 2013 

 Kathleen Sebelius Date

II. Employee Class Definition

All employees of the Department of Energy, its predecessor agencies, and their 

contractors and subcontractors who worked at the Pantex Plant in Amarillo, Texas 

from January 1, 1984, through December 31, 1991, for a number of work days 

aggregating at least 250 work days, occurring either solely under this employment or 

in combination with work days within the parameters established for one or more 

other classes of employees included in the SEC. 

III. Designation Criteria and Recommendations

Pursuant to 42 U.S.C. § 7384q, for the class defined in Section II of this report, the Secretary 

has determined, and the Advisory Board on Radiation and Worker Health (Board) has 

recommended, that 

(1) it is not feasible to estimate with sufficient accuracy the radiation dose that the class 

received; and

(2) there is a reasonable likelihood that such radiation dose may have endangered the 

health of members of the class.

The SEC final rule states in 42 C.F.R. § 83.13(c)(1) that it is feasible in two situations to 

estimate the radiation dose that the class received with sufficient accuracy. First, the rule 

states that radiation doses may be estimated with sufficient accuracy if NIOSH has 

established that it has access to sufficient information to estimate the maximum radiation 

dose for every type of cancer for which radiation doses are reconstructed that could have been 

incurred under plausible circumstances by any member of the class. Alternatively, radiation 

doses may be estimated with sufficient accuracy if NIOSH has established that it has access 

to sufficient information to estimate the radiation doses of members of the class more 

precisely than a maximum dose estimate.

The Board, pursuant to 42 U.S.C. § 7384q, advised the Secretary to designate the class as an 

addition to the SEC in a letter received by the Secretary on September 3, 2013. 
HHS Special Exposure Cohort Designation:

Pantex Plant, Amarillo, Texas Page 3

IV. Designation Findings 

Feasibility of Estimating Radiation Doses with Sufficient Accuracy

The Secretary established the feasibility determination for the class of employees covered by 

this report based upon the findings summarized below. 

The principal sources of internal radiation doses for members of the proposed class 

were tritium, uranium, and thorium. 

• Doses from tritium could be reconstructed using the available tritium 

bioassay data; however, it is not feasible to reconstruct internal doses 

from uranium and thorium.

• NIOSH lacks sufficient uranium urinalysis samples for the years 1984-1990. 

Although NIOSH has obtained 301 samples collected from workers in 1990 in 

response to concerns about contamination resulting from the final disassembly 

of the W28 weapons system, there is evidence (such as worker interviews and 

presence of enriched uranium in urinalysis samples) suggesting that the W28 

weapons system may not constitute the highest uranium exposure potential 

among all other operations at Pantex. Additionally, the routine bioassay program 

at Pantex was not fully implemented in 1990. Therefore, an intake calculation 

based on the urinalysis results from W28 workers would not bound uranium 

exposures for all workers at Pantex.

• NIOSH also lacks dose reconstruction methods for bounding thorium internal 

exposures. NIOSH initially proposed to estimate thorium intakes during the 

years 1984-1991 at 2% of uranium intakes. For the years 1984-1990, 

reconstruction of thorium internal exposures is not feasible because they 

depended on intakes of uranium which, as discussed above, could not be 

reconstructed. For the year 1991, NIOSH could not use the measurements of 

airborne thorium and uranium taken during the mid-90’s because those 

measurements do not represent the exposure level in 1991. Consequently, 

NIOSH could not reconstruct dose for internal thorium exposure for 1984-

1991. 

• Consequently, the Board concluded, and the NIOSH Director concurred, that 

NIOSH lacks sufficient information, which includes specific biological 

monitoring data, air monitoring information, process and radiological source 

information, and surrogate data from similar operations at other sites that 

would allow it to estimate the internal uranium exposures for the time period 

from January 1, 1984, through December 31, 1990, and the internal thorium 

exposures for the time period from January 1, 1984 through December 31, 

1991. In sum, reconstruction for the total internal dose is not feasible for all 

workers at the Pantex Plant from January 1, 1984, through December 31, 

1991. 
HHS Special Exposure Cohort Designation:

Pantex Plant, Amarillo, Texas Page 4

• The principal sources of external radiation doses for members of the proposed 

class were plutonium pits and depleted uranium and thorium components. 

Secondary sources of external exposure included other radioactive materials 

present in smaller quantities (typically microcurie levels) as calibration

sources or in larger quantities (up to curie levels) as radiography sources 

(ORAUT-TKBS-0013-2).

• NIOSH concluded it is feasible, using methods available in existing NIOSH 

procedures, to reconstruct external radiation doses, including the x-ray dose, 

when appropriate, for all Pantex workers from January 1, 1984, through 

December 31, 1991. 

• The Board concurred with NIOSH that external doses could be reconstructed 

for all years, using the available external monitoring data for Pantex workers, 

adjusted during some periods to account for the performance of the 

monitoring devices. 

• Although NIOSH now finds that it is not possible to completely reconstruct internal 

radiation doses for the period from January 1, 1984, through December 31, 1991, 

NIOSH intends to use any internal monitoring data that may become available for an 

individual claim (and that can be interpreted using existing NIOSH dose 

reconstruction processes or procedures). Dose reconstructions for individuals 

employed at the Pantex Plant during the period from January 1, 1984, through 

December 31, 1991, but who do not qualify for inclusion in the SEC, may be 

performed using these data as appropriate.

• Pursuant to 42 C.F.R. § 83.13(c)(1), NIOSH determined that there is insufficient 

information to either: (1) estimate the maximum radiation dose, for every type of 

cancer for which radiation doses are reconstructed, that could have been incurred 

under plausible circumstances by any member of the class; or (2) estimate the 

radiation doses of members of the class more precisely than a maximum dose 

estimate.

• The Board recommended, and the NIOSH Director concurred with, the proposed 

class for addition to the SEC.

 Health Endangerment 

The Secretary established the health endangerment determination for the class of employees 

covered by this report based upon the findings summarized below.

(1) Pursuant to 42 C.F.R. § 83.13(c)(3), the NIOSH Director established that there is a 

reasonable likelihood that such radiation doses may have endangered the health of 

members of the class. Pursuant to 42 C.F.R. § 83.13(c)(3)(ii), the NIOSH Director 

specified a minimum duration of employment to satisfy this health endangerment 

criterion as “having been employed for a number of work days aggregating at least 

250 work days within the parameters established for this class or in combination with 

work days within the parameters (excluding aggregate work day requirements) 

established for one or more other classes of employees in the Cohort.” 
HHS Special Exposure Cohort Designation:

Pantex Plant, Amarillo, Texas Page 5

(2) The Board and the NIOSH Director did not identify any evidence from the petitioners 

or from other resources that would establish that the class was exposed to radiation 

during a discrete incident likely to have involved exceptionally high-level exposures, 

such as a nuclear criticality incident, as defined under 42 C.F.R. § 83.13(c)(3)(i). 

(3) The NIOSH Director concurred with the Board’s finding that the health of the class 

may have been endangered and defined the class according to the 250-work day 

requirement specified under 42 C.F.R. § 83.13(c)(3)(ii).

V. Effect and Effective Date of Designation

The Secretary submits this report on the designation of one additional class to the SEC for 

review by Congress, pursuant to 42 U.S.C. §§ 7384l(14)(C)(ii) and 7384q(c)(2)(A), as 

amended by the Ronald W. Reagan National Defense Authorization Act for Fiscal Year 2005, 

Pub. L. No. 108-375 (codified as amended in scattered sections of 42 U.S.C.). Pursuant to 42 

U.S.C. § 7384l(14)(C)(ii), as amended by the Ronald W. Reagan National Defense 

Authorization Act for Fiscal Year 2005, Pub. L. No. 108-375 (codified as amended in 

scattered sections of 42 U.S.C.), the designation in this report will become effective 30 days 

after the date of this report’s submission to Congress “unless Congress otherwise provides.” 

VI. Administrative Review of Designation

The health endangerment determination of the designation provided in this report may be 

subject to an administrative review within HHS, pursuant to 42 C.F.R. § 83.18(a). On the 

basis of such a review, if the Secretary decides to expand the class of employees covered by 

this designation, the Secretary would transmit a supplementary report to Congress providing 

the expanded employee class definition and the criteria and findings on which the decision 

was based.